Helping Babies Sleep Safer

WHAT IS FLAT HEAD?

(plagiocephaly)

Positional plagiocephaly is a disorder in which the back or one side of an infant's head is flattened, caused by repeated pressure to one side of the back of the soft infant skull.

How is Plagiocephaly Prevented?

Changing Sleeping Conditions

Parents often face a conundrum: one should place a healthy sleeping baby on his or her back to reduce the risk of SIDS, but doing so may lead to plagiocephaly. Luckily, parents do not have to worry about either when their baby is sleeping in the supine position on a Lifenest. The physician-designed Lifenest Mattress Topper helps prevent plagiocephaly in several ways:

Lifenest's mattress topper cradles the babies head.

The increased contact surface reduces the pressure per square inch on the head.

The Lifenest’s comfortable and supportive netting allows a baby’s head to move freely.

During supervised “Tummy Time,” the baby may breathe through the netting.

Flat Head Prevention Before Lifenest

Techniques for repositioning include supervised “Tummy Time,” switching the direction that your baby lies in the crib, and changing the location of the baby’s crib.

Talk to your health care provider about your baby’s head shape at each checkup.

What are the danger in have Plagiocephaly?

Skull Distortion and Facial Asymetry

Deformational plagiocephaly produces an undesirable effect on a baby’s aesthetic appearance. Flat head syndrome not only lead to distortion of the skull shape, but sometimes also facial asymmetry, often with little hair growing in the flattened area.
In severe plagiocephaly cases:

One eye appears larger than the other.

The ear on the flattened side is pushed forward more than the other side.

Eye alignment varies.

One cheek appears fuller than the other.

Neurodevelopmental Damage

Even though flat head syndrome was considered to be a purely aesthetic problem in the past, a recent case-control study led by Matthew L. Speltz, PhD at the Seattle Children Hospital, which included 235 infants with deformational plagiocephaly and 237 normal infants, found that the infants with plagiocephaly had significantly lower scores on neurodevelopmental tests.

Types of Positional Skull Deformation (Flat Head Syndrome)

PLAGIOCEPHAL

Oblique head shape, resulting from pressure on one side of an infant’s head.

BRACHYCEPHALY

Wide head shape, resulting from pressure on the back of an infant’s head.

DOLICOCEPHALY

Narrow head shape, resulting from pressure on both sides of an infant’s head.

What causes Plagiocephaly?

The Naturally Soft Infant Skull

Typically, the average skull is one third longer than it is wide. Passage through the birth canal often makes a newborn's head appear pointy or elongated for a few days. Because infants' heads are soft to allow for the incredible brain growth that occurs in the first year of life, they're more susceptible to being "molded" into a flat shape.

Premature infants and infants who require placement in Newborn Intensive Care Units (NICU) are prone to positional plagiocephaly because their skulls are softer and they spend the majority of their time on their backs.

Supine Sleeping Position (Lying on Back)

Placing healthy young infants to sleep on their backs (for SIDS prevention) is associated with a 40% increase in deformational plagiocephaly.

As the infant spends more time in the supine position, or reclining with his or her head on a hard surface (such as in cribs, strollers, swings and playpens), the occiput is more likely to become deformed.

Positional plagiocephaly can also be developed before birth if the mother’s pelvis or a twin is exerting strenuous force on a baby. In fact, it is common to see plagiocephaly in multiple birth infants.

HOW IS PLAGIOCEPHALY DIAGNOSED?

Observational Diagnosis

Most often, the diagnosis does not require X-rays or lab tests. A simple examination by a doctor is generally enough to make the diagnosis of positional plagiocephaly.

Positional plagiocephaly is generally easy for parents to notice. When looked at from above the baby’s head, one ear may appear more forward than the other. A "parallelogram" skull shape strongly suggests deformational plagiocephaly.

HOW COMMON IS PLAGIOCEPHALY?

Extremely High Incidence

Over the past several years, pediatricians have seen an increase in the number of children with cranial asymmetry, particularly unilateral flattening of the back of the head (occiput). Currently, deformational plagiocephaly has reached epidemic proportions.

This increase is likely attributable to parents following the American Academy of Pediatrics "Back-to-Sleep" positioning recommendations aimed at decreasing the risk of SIDS (Sudden Infant Death Syndrome).

HOW IS PLAGIOCEPHALY TREATED?

Custom Helmet or Band

More severe cases of positional plagiocephaly must be treated with a custom helmet or custom band that would need to be worn for 23 hours a day, for several months.

If you're starting late, your baby's skull may not become perfectly symmetrical..

Sources

1. M. L. Speltz, PhD, B. R. Collett, PhD, M. Stott-Miller, MS, 2010, Case-Control Study of Neurodevelopment in Deformational Plagiocephaly, Pediatrics, Vol. 125 No. 3 March 1st, 2010, e537-e542 The contents of this page, such as text, graphics, images, and other material are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.